Several very effective types of varicose vein treatments are available. When performed by doctors with the right training and plenty of experience, they can be very effective. They include:
Endovenous Laser Treatment
To correctly determine if a patient actually has varicose veins, a doctor conducts a duplex ultrasound that determines if there is saphenous vein insufficiency (see how to legally offer laser treatment). This is the most common cause leading to the formation of varicose veins. Once the diagnosis is made, the doctor will determine if endovenous laser treatment is the right way to correct it.
This type of laser treatment takes 30 to 45 minutes and can be performed in the doctor’s office. There is no downtime and no scarring. In most cases, the skin is numbed before the treatment and the vein is accessed through the skin using with the guidance of ultrasound and through the use of a catheter inserted into the vein. A laser filament is put through the catheter and ultrasound verifies its placement. A numbing solution of saline with lidocaine is introduced, then the energy is emitted from the laser as it is slowly withdrawn. This energy causes the vein to seal shut.
When the process is complete, a compression dressing is worn on the treated leg for 2 days followed by a week of compression stockings usage. Most patients return to work the day after the procedure.
Doctors often make the following recommendations:
- Wear compression stockings 24 hours a day for a week, then during the day for 3 more weeks.
- Avoid running, aerobics and other high-impact activities for 3 weeks.
- Walking is to be encouraged because it can assist in the healing process.
An ultrasound is performed 3 to 7 days after the procedure to check deep veins and again 4 weeks later to make sure veins have sealed off. Treated veins can occasionally reopen, and then an injection of a foam sclerotherapy agent or another laser treatment is required. As many as 98 percent of veins remain shut a year later.
Some mild side effects are possible. This can include redness in the treated area that fades within a few days. There may also be some swelling.
Advanced Varicose Vein Treatment With The TriVex System
The TriVex system is a newer and safer way to treat people with varicose veins that can be more effective. Patients are sometime resistant to varicose vein treatment because of the possibility of pain and long recuperation times. The TriVex system is minimally invasive and allows patients to walk out of the hospital with hardly any scarring — and there’s almost no pain within two weeks or so.
The system is used during a special surgical procedure transilluminated power phlebectomy. In this case, light is passed through the skin to aid in the vein removal. The surgeon looks at the vein with the aid of a special light and does the vein removal with a special surgical device.
While standard varicose vein removal is done blind — that is, the surgeon can’t always see what he or she is doing — the TriVex system allows for unique illumination so the surgeon can rapidly and accurately find the vein visually and make sure it is extracted completely. This means extraction is more effective, more complete and less traumatic for the patient since fewer incisions are necessary to do the surgery and the surgery can be completed more quickly. Studies indicate there is less pain and a reduced chance of post-operative infection with this type of varicose vein removal.
The procedure is done as an outpatient and often takes less than an hour to complete. Studies have indicated that this is about half the time as compared with the older hook method and that the number of incisions is reduced by 50 to 75 percent. The research has also shown that there is a need for less anesthesia — and less pain after the procedure.
These things taken together mean that the TriVex system is a safer and better way to treat varicose veins than the old-fashioned methods.
Varicose Vein Treatment Progression
Treatment of varicose veins has progressed tremendously in recent years. Once the hook technique was the most common, but complications of this method included:
- tediousness for the doctor
- difficulty of the procedure to perform
- possibility that it would leave the process incomplete
- requiring of multiple incisions
- difficulty of hiding incisions
- outdated nature of the procedure
- painful, lengthy recovery period
Surface Laser Treatment
Used to get rid of spider veins, surface laser treatment involves the use of a laser bean outside the skin aimed at the veins and the closing of those veins without an incision in the skin.
Since skin pigmentation can impede laser effectiveness, the patient is instructed to avoid sun exposure for 4 weeks before treatment. This can also lessen the chance of scarring and blistering.
While discomfort from this procedure is mild, some type of cooling may be used to make the patient more comfortable. This can involve ice, cool air or a topical anesthetic. The number and length of sessions will vary based on the location and severity of the treatment area. Often, facial veins can be treated in a single session while most locations on the legs need 3 to 5 treatments to get rid of all spider veins. Treatments are performed 4 to 6 weeks apart.
The best physicians use what is called the double injury method for treating spider veins on the leg. This involves treatment with the D940 SkinPulse S laser or a similar device followed by the injecting of a sclerosing solution into the feeder vein for the area. Laser energy is applied initially through a small, light handpiece. The size of the energy beam is determined by the size of the area being treated. By treating the vein with the laser before attempting sclerotherapy, the vein goes into spasm, meaning that less of the sclerotherapy solution is necessary. This means patients get quicker resolution and a decreased risk of skin staining a brownish color.
After this type of procedure is completed, wearing a compression stocking fro 3 to 5 days is recommended. There may be mild side effects like slight redness or mild swelling of the area treated.
The following guidelines are also suggested to the patient:
- Avoid sun and tanning beds for a month before and after treatment.
- Wear compression stockings for 3 to 5 days.
- Avoid stressful activities like running or aerobics for 3 weeks.
- Walk as much as desired to help improve healing.
While discomfort is mild, cooling is sometimes done to increase comfort. This is done with ice, cool air or a topical treatment. If multiple treatments are required as is sometimes the case, treatments are usually performed about 4 to 6 weeks apart.
Sclerotherapy
Used to treat small and medium reticular veins that supply blood to spider veins or small varicose beings that persist after endovenous laser treatment as well as perforator veins that can lead to skin ulcers and other situations, sclerotherapy is performed with ultrasound or visual guidance. The procedure involves the insertion of a tiny needle and the injection of a foam sclerosant into the vein. This causes swelling in the lining of the vein that causes it to eventually seal closed. The vein will fade away over the course of a few weeks.
Like with laser treatment, 3 to 5 sessions may be required. Possible side effects include staining or brown discoloration of the skin that can take 6 months or more to fade away before normal pigmentation returns.
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